Individual
MR. RON ANTHON OLSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
20185 E OCOTILLO RD STE 105, QUEEN CREEK, AZ 85142-7663
(480) 677-3600
(480) 677-3645
Mailing address
PO BOX 2240, QUEEN CREEK, AZ 85142-1846
(520) 510-3200
(480) 655-5523
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
AZ0372
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1467564897
GROUP NPI
—
05
—
159782
—
AZ
01
—
1972510675
PROVIDER BILLING ONLY
AZ
Enumeration date
08/02/2006
Last updated
03/01/2019
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